Trends in hard-core drug use

One survey that does capture the traditional high-risk populations is the Drug Abuse Warning Network (DAWN), which monitors the number and pattern of drug-related emergencies and deaths in 21 major metropolitan areas across the country. DAWN is closely watched as a bellwether of hard-core use because so many emergency room cases involve addicts and heavy users.

In 1995, the DAWN results were scrutinized for possible vindication of the Clinton Administration's controversial focus on rehabilitating hardcore drug addicts. President Clinton announced the policy shift in a message to Congress, in which he wrote of "chang[ing] the focus of drug policy by targeting chronic, hardcore drug users."(NOTE 8)

Unfortunately, the latest DAWN results contained nothing but bad news.(NOTE 9) As Figure D illustrates , cocaine-related episodes hit their high-est level in history. Marijuana-related episodes jumped 39 percent-and are running at 155 percent above the 1990 level. Methamphetamine cases rose 256 percent over the 1991 level, as shown in Figure F , portending a potential epidemic of methamphetamine abuse as Mexican laboratories ensure a steady, cheap supply of the stimulant.

Heroin-related episodes, which had jumped 66 percent in 1993, remain at the same high level as last year, although significant jumps were noted in specific metropolitan areas. In Baltimore, for example, the rate of emergency room admissions increased by 54 percent, from 259 to 398 per 100,000 population, between 1993 and 1994. (NOTE 10)

According to the Department of Health and Human Services, (HHS) increases in emergency room admissions are being driven in part by drug overdoses, by the chronic effects of drug use, and by addicts seeking "detox." As shown in Figure E , a record number of emergency room admissions are for hard-core users, the very population that the Clinton Administration drug strategy promised to reduce.